Scirrhous Carcinoma Research Articles

Analytical Modeling of Breast Elastography

The purpose of the research is to develop a method for assessing the level of nonspecific protection of the body. Тhe purpose of the research. Тo develop an analytical method based on micromechanics to determine the location, size and modulus of elasticity of a tumor mass embedded in symmetrical double-dimensional breast tissue and obtain a closed solution for deformation elastograms.Methods. Changes in tissue elasticity usually correlate with pathological phenomena. Many cancers, such as scirrhous carcinoma of the breast, appear as extremely hard nodules that result from increased stromal density. Other diseases include deposits that increase or decrease tissue elasticity. Complex fluid-filled cysts may not be visible on standard ultrasound, but may be much softer than the embedded tissue. Тhe elastic moduli of tumors change during their pathological evolution. Еlastographic imaging has the potential to detect and characterize cancers by mapping tissue stiffness distribution. Тhe work developed a model of the mammary gland in the form of a two-dimensional layer of unit thickness with a round tumor, taking into account boundary conditions. Local elastic responses were obtained when an acoustic field was applied.Results. Тo evaluate the possibilities of determining the quantitative values of the elastic modules of the medium, we proposed a model of the process of deformation of heterogeneity under the conditions of ultrasonic static elastography and investigated the influence of elastic moduli and deformation of heterogeneity in the direction of applied pressure. Conclusion. Тhe developed technique made it possible to obtain an analytical solution for the field of deformations and stresses of two-dimensional models of mammary glands containing inhomogeneities. Тhe model makes it possible to use the developed methodology for constructing medical elastographic devices and conducting research in the field of elastography.

A case of severe immune checkpoint inhibitor-related gastritis requiring differential diagnosis from scirrhous carcinoma

A case of severe immune checkpoint inhibitor-related gastritis requiring differential diagnosis from scirrhous carcinoma

Cardiac tamponade due to advanced gastric cancer: a pathomorphological systematic review of clinical cases

Annotation. Pericardial involvement due to gastric cancer is uncommon, especially when it’s secondary to direct transdiaphragmatic tumor infiltration, and its manifestation in the form of cardiac tamponade is an exceptional situation. The aim of this review is to provide a pathomorphological overview of three rare clinical cases of cardiac tamponade, which was the first clinical manifestation of advanced gastric cancer. To realize the goal, a meta-analysis of 15 publications included in the Medline and Scopus scientific databases was conducted. The statistical substantiation of the research was carried out using Microsoft Excel 2016 and Statistica 12.0. According to the results of histological analysis, these three cases of gastric cancer were classified as: poorly differentiated adenocarcinoma of the antrum in a 52-year-old patient; sarcomatoid carcinoma of the fundus in a 49-year-old patient; and scirrhous carcinoma of the fundus in a 70-year-old patient. The tropism of gastric tumor infiltration into the pericardium is substantiated with the help of transforming growth factor, which increases the expression of CD44 adhesion molecules in tumor cells and stimulates the ability of the tumor to infiltrate the pericardium due to adhesion to the mesothelium. The hepatocyte growth factor, which enhances the invasive properties of the tumor, also played an important role: the C-Met receptors were determined on tumor cells in all cases. Thus, cardiac tamponade, which is a terminal condition, can occur in patients with various histological types of gastric cancer, including the three described. Furthermore, in the medical literature this over review is probably the only one attempt to analyze cardiac tamponade due to advanced gastric cancer with a comparison of different clinical cases.

25, 50 and 75 years ago

25, 50 and 75 years ago

Carcinoma en cuirasse of breast presenting as keloidal structures

Abstract Carcinoma en cuirasse, also known as scirrhous carcinoma, is a form of cutaneous metastasis of breast carcinoma. The incidence of “en cuirasse” is approximately 0.6%–10% of cases. The most common sites for cutaneous metastases are the chest wall and abdomen. It is characterized by an erythematous, indurated plaque, nodules, or morphea-like plaques over the chest wall. We report a rare case of carcinoma en cuirasse of breast presenting as keloidal-like nodules in a 55-year-old woman.

Epidemiological and Clinical Characteristics of Five Rare Pathological Subtypes of Hepatocellular Carcinoma.

BackgroundHepatocellular carcinoma (HCC) is a highly heterogeneous tumor with several rare pathological subtypes and which is still poorly understood. This study aimed to describe the epidemiological and clinical spectrum of five rare HCC subtypes and develop a competing risk nomogram for cancer-specific survival prediction.MethodsThe study cohort was recruited from the Surveillance, Epidemiology, and End Results database. The clinicopathological data of 50,218 patients histologically diagnosed with classic HCC and five rare subtypes (ICD-O-3 Histology Code = 8170/3-8175/3) between 2004 and 2018 were reviewed. The annual percent change (APC) was calculated utilizing Joinpoint regression. The nomogram was developed based on multivariable competing risk survival analyses. Akaike information criterion, Bayesian information criterion, C-index, calibration curve, and area under the receiver operating characteristic curve were obtained to evaluate the prognostic performance. A decision curve analysis was introduced to examine the clinical value of the models.ResultsDespite scirrhous carcinoma, which showed a decreasing trend (APC = -6.8%, P = 0.025), the morbidity of other rare subtypes remained stable from 2004 to 2018. The incidence-based mortality was plateau in all subtypes during the period. Clear cell carcinoma is the most common subtype (n = 551, 1.1%), followed by subtypes of fibrolamellar (n = 241, 0.5%), scirrhous (n = 82, 0.2%), spindle cell (n = 61, 0.1%), and pleomorphic (n = 17, ~0%). The patients with fibrolamellar carcinoma were younger and more likely to have a non-cirrhotic liver and better prognoses. Scirrhous carcinoma shared almost the same macro-clinical characteristics and outcomes as the classic HCC. Clear cell carcinoma tended to occur in the Asia-Pacific elderly male population, and more than half of them were large HCC (Size>5cm). Sarcomatoid (including spindle cell and pleomorphic) carcinoma was associated with a larger tumor size, poorer differentiation, and more dismal prognoses. The pathological subtype, T stage, M stage, surgery, alpha-fetoprotein, and cancer history were confirmed as the independent predictors in patients with rare subtypes. The nomogram showed good calibration, discrimination, and net benefits in clinical practice.ConclusionThe rare subtypes had unique clinicopathological features and biological behaviors compared with the classic HCC. Our findings could provide a valuable reference for clinicians. The constructed nomogram could predict the prognoses with good performance, which is meaningful to individualized management.

PODXL1 promotes metastasis of the pancreatic ductal adenocarcinoma by activating the C5aR/C5a axis from the tumor microenvironment

Pancreatic invasive ductal adenocarcinoma (PDAC) is a representative intractable malignancy under the current cancer therapies, and is considered a scirrhous carcinoma because it develops dense stroma. Both PODXL1, a member of CD34 family molecules, and C5aR, a critical cell motility inducer, have gained recent attention, as their expression was reported to correlate with poor prognosis for patients with diverse origins including PDAC; however, previous studies reported independently on their respective biological significance. Here we demonstrate that PODXL1 is essential for metastasis of PDAC cells through its specific interaction with C5aR. In vitro assay demonstrated that PODXL1 bound to C5aR, which stabilized C5aR protein and recruited it to cancer cell plasma membranes to receive C5a, an inflammatory chemoattractant factor. PODXL1 knockout in PDAC cells abrogated their metastatic property in vivo, emulating the liver metastatic mouse model treated with anti-C5a neutralizing antibody. In molecular studies, PODXL1 triggered EMT on PDAC cells in response to stimulation by C5a, corroborating PODXL1 involvement in PDAC cellular invasive properties via specific interaction with the C5aR/C5a axis. Confirming the molecular assays, histological examination showed coexpression of PODXL1 and C5aR at the invasive front of primary cancer nests as well as in liver metastatic foci of PDAC both in the mouse metastasis model and patient tissues. Hence, the novel direct interaction between PODXL1 and the C5aR/C5a axis may provide a better integrated understanding of PDAC biological characteristics including its tumor microenvironment factors.

Measurement and Analysis of Complex Permittivity of Breast Cancer in Microwave Band.

In order to obtain the basic data of breast cancer detection by microwave imaging, the complex permittivity of tissue excised from a breast cancer surgery was measured and analyzed. The relative permittivity and the conductivity of each tissue have strong linearity. In 80% of cases the relative dielectric constant and conductivity of the cancer tissue were higher than those in the breast tissue. However, in the remaining 20% case (scirrhous carcinoma) the dielectric constant and conductivity of the mammary gland were higher in those of cancer. We found that it is necessary to examine diagnostic approach of the reconstructed image by microwave imaging.

Abstract 5160: Extracellular vesicles from scirrhous gastric cancer cells induce premetastatic niche formation for peritoneal metastasis

Abstract Background: Human scirrhous gastric carcinoma (SGC) is also known as diffusely infiltrating carcinoma, type 4 on Borrmann’s criteria, and linitis plastica-type carcinoma. SGC is characterized by frequent peritoneal metastasis, high proliferation and infiltration activity with extensive fibrosis in the tumor stroma. We previously reported that a soluble factor(s) from SGC cells changed the peritoneum to pre-metastatic niche such as round shape of mesothelial cells and peritoneal fibrosis, which is a favorable environment for cancer cells to metastasize. Extracellular vesicles (EVs; Exosomes) might be one of soluble factor(s) which might change the peritoneal component to pre-metastatic niche. In this study, we investigated the effect of EVs from SGC cells on the pre-metastatic niche formation of the peritoneum. Methods: Four SGC cell lines, OCUM-2M, OCUM-2MD3, OCUM-12, KATO-III, 2 non-SGC cell lines, MKN74, MKN45, and peritoneal mesothelial cells (PM cells) were used. The effect of EVs from gastric cancer cells on the peritoneum was examined in vitro and in vivo, as follows. PKH26-labeled EVs from OCUM-2MD3 cells were intravenously injected into nude mice for 3 weeks, then we examined the distribution of PKH26-labeled EVs by a fluorescence microscope. Next, we injected EVs intraperitoneally into nude mice, and investigated the morphology of peritoneum. Effect of EVs on the gene expression of PM cells was examined by RT-PCR. Clinical significance of EVs markers, CD9 and CD63, was evaluated by immunohistochemistry using 63 human gastric cancer specimens. Results: PKH26-labeled EVs frequently distributed to peritoneum and the liver. The morphology of PM cells changed from round shape to spindle shape by EVs addiction in vitro and in vivo. mRNA expression level of ZEB and N-cadherin of PM cells was significantly increased following the addiction of EVs. The high expression of EVs markers, CD9 and CD63, was significantly correlated with frequent peritoneal metastasis. Conclusion: EVs from SGC cells might frequently distribute to mesothelial cells of peritoneum. EVs from SGC cells might play an important role for the formation of a pre-metastatic niche on peritoneum by the morphologic change of peritoneal mesothelial cells. Citation Format: Tomohisa Okuno, Masakazu Yashiro, Shuhei Kushiyama, Sadaaki Nishimura, Shingo Togano, Kenji Kuroda, Tatsuro Tamura, Takahiro Toyokawa, Hiroaki Tanaka, Kazuya Muguruma, Kosei Hirakawa, Masaichi Ohira. Extracellular vesicles from scirrhous gastric cancer cells induce premetastatic niche formation for peritoneal metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5160.

Cancer information needs according to cancer type: A content analysis of data from Japan's largest cancer information website.

The provision of information about cancer is an important aspect of cancer care. Cancer information provided online is expected to meet the needs of information seekers. Whether information needs vary according to tumor site is largely unknown. We aimed to examine similarities and differences in informational needs by cancer type. Data were collected using a questionnaire administered on Japan's largest cancer information website, “Ganjoho service”. A total of 2782 free descriptive responses in the period from April 2012 to December 2017 were analyzed using text-mining software. We identified the top 10 informational need contents, in order of appearance frequency, for eight tumor sites: gastric, colorectal, esophageal, lung, pancreatic, breast, cervical, and prostate cancer. Frequent information needs common to all tumor sites included symptoms, disease stages, treatments, chance of cure, recovery, metastasis, and recurrence. A need for information about diet, pain, side effects of treatments, complementary and alternative medicine was frequent for some tumor sites. Tumor site-specific information should include the following, according to cancer type: information of scirrhous carcinoma for gastric cancer; unusual feces for colorectal cancer; lung X-ray images for lung cancer; early detection for pancreatic cancer; adenocarcinoma, sexual activity, pregnancy, and childbirth for cervical cancer; breast conservation or reconstruction and triple negative cancer for breast cancer; test values and diagnosis and urinary problems for prostate cancer; and hormone therapy for breast and prostate cancer. Cancer information provided online should meet these frequent informational needs, considering similarities and differences of the information required according to tumor site.

Multiple hepatic sclerosing hemangiomas: a case report and review of the literature

BackgroundHepatic sclerosing hemangioma, a very rare benign tumor, is characterized by fibrosis and hyalinization occurring in association with degeneration of a hepatic cavernous hemangioma. Such atypical hemangiomas can be diagnosed incorrectly as primary or metastatic malignancies based on imaging characteristics. We present herein a rare case of giant and multiple hepatic sclerosing hemangiomas that are difficult to differentiate from hepatic malignancies and review the relevant literature.Case presentationThe patient was a 48-year-old male who was found to have multiple hepatic tumors and a giant tumor (67 × 53 mm) superior to the inferior vena cave by an abdominal ultrasonography during a routine medical examination. The patient was referred to our hospital for further evaluations and diagnosis of the multiple hepatic tumors. Dynamic CT showed low-density tumors in the delayed phase suggestive of membrane-covered lesions. EOB-MRI demonstrated a mass with low-signal intensity mass on T1-weighted images and areas of high-signal intensity on T2-weighted images and a hypointense mass in the hepatobiliary phase, which showed high intensity on DWI-based ADC map. FDG-PET showed no accumulation of [18F]-FDG. A provisional diagnosis of multiple scirrhous hepatocellular carcinomas was made on the basis of these imaging studies, and caudate lobectomy of the liver and partial hepatectomy of S2 and S6 were performed. Histopathological examination showed that the tumors were composed of various sized irregularly dilated vessels with some blood thrombi, inflammatory cell infiltration, fibrous and hyalinized sclerotic or myxomatous stroma, resulting in a diagnosis of multiple hepatic sclerosing hemangiomas.ConclusionsDifferentiation of multiple sclerosing hemangiomas from other hepatic malignant tumors, such as intrahepatic cholangiocarcinoma, metastatic liver cancer, and scirrhous hepatocellular carcinoma characterized by abundant fibrous stroma, is difficult because the radiological findings are very similar. Inclusion of hepatic sclerosing hemangioma in the differential diagnosis of multiple liver tumors could enable optimal management; this possibility is important to consider before planning invasive therapies.

Characteristics and prognosis of Japanese female breast cancer patients: The BioBank Japan project.

BackgroundBreast cancer is currently the most common type of cancer in Japanese females. Unlike most other types of cancer, breast cancer develops more frequently in middle-aged females than in elderly females.MethodsOf all Japanese female breast cancer patients aged ≥20 years whom the BioBank Japan Project originally enrolled between 2003 and 2008, 2034 were registered within 90 days after their diagnosis. We described the lifestyle and clinical characteristics of these patients at study entry. Furthermore, we examined the effect of these characteristics on all-cause mortality.ResultsIn the female patients registered within 90 days after diagnosis, the frequency of stage 0 or unclassified, stage I, II, III and IV were 11.4%, 47.9%, 37.0%, 2.9% and 0.8%, respectively. The proportion of histological types was 12.9% for non-invasive carcinoma (ductal carcinoma and lobular carcinoma), 81.0% for invasive carcinoma (papillotubular carcinoma, solid tubular carcinoma, scirrhous carcinoma and special types), 0.2% for Paget's diseases and 5.8% for others. Those positive for the estrogen and progesterone receptors accounted for 75.8% and 62.1% of all patients, respectively. Among 1860 female participants registered within 90 days, 218 participants died during 144,54 person-years of follow-up. More advanced stage, elevation of serum carcinoembryonic antigen and carbohydrate antigen 15-3 levels and absence of the estrogen receptor at study entry were crudely associated with an increased risk of all-cause mortality after adjustment for age.ConclusionsThis study showed the association of several clinical characteristics with all-cause mortality in female breast cancer patients.

Bone Marrow-Derived Mesenchymal Stem Cells Regulate Epithelial-Mesenchymal Transitions and Gastric Cancer Stem Cells

Tumorigenesis is driven by alterations in tumor cells and also changes in the stromal microenvironment. Mesenchymal stem cells (MSCs) are promising candidates for the treatment of various tumors. MSCs are unlikely to be rejected by the immune system, could potentially home to the tumor site, and may interact with tumor cells to influence their growth and metastasis. Using mouse models of inflammation-induced gastric cancer, at least 20% of cancer-associated fibroblasts were found to originate from bone marrow (BM) and were derived from MSCs. Direct contact between BM-derived MSCs (BM-MSCs) and gastric cancer cells in vitro increases the proportion of CD133-positive gastric cancer cells. This mechanism is thought to involve stimulation of Wnt-5a and transforming growth factor (TGF)-β by BM-BMCs, directly affecting the gastric cancer cells. Moreover, direct contact between BM-MSCs and gastric cancer cells increases the expression of vimentin and Snail, which is a transcription factor that mediates epithelial-mesenchymal transitions (EMT). Human BM-MSCs can enhance the proliferation, invasion, and chemoresistance of gastric cancer cells. The regulatory mechanism involved is likely associated with increased expression of stem cell markers and EMT-related factors in gastric cancer cells. CD271, which is a marker of BM-MSCs, is expressed in scirrhous carcinoma, and the expression of Wnt-5a and TGF-β in cancer cells is up-regulated.BM-MSCs provide an advantageous tumor microenvironment for gastric cancer. Moreover, BM-MSC-related molecules may be considered biomarkers of gastric cancer.

Computer Aided Detection of Breast Cancer on Ultrasound Imaging Using Deep Learning

Although breast ultrasound imaging is powerful and effective tool to detect breast lesions and have been widely performed worldwide, it is an operator-dependent test, hence the accuracy for detection and diagnosis of breast lesions depend on the operator. We develop a computer-aided detection system for masses in ultrasound image using deep convolutional neural network. A data set containing 818 ultrasound images were collected from our institute. Breast lesions on these images were cropped as 256x256 pixel images manually. All images were flipped horizontally and were collected to make new images. After data augmentation, a total of 2604 images were obtained. These images were labeled and classified by histological tissue type: cyst, concentrated cyst, ductal carcinoma in situ, fibroadenoma, intraductal papilloma, lymph node, invasive lobular carcinoma, mastitis, mastopathic change, mucinous carcinoma, invasive papillotubular carcinoma, phyllodes, tumor, invasive scirrhous carcinoma or invasive solidtubular carcinoma. For training and testing, the data set was randomly divided into a training set and an independent test set with a ratio of 80:20. Classification of data set images were trained using convolutional neural network(CNN) with ten hidden layers including convolutional layers and pooling layers. Its accuracy of classification was evaluated. Data set was also classified as either benign or malignant, and trained using CNN. Its accuracy, sensitivity and specificity were also evaluated. Images were classified as 14 tissue type and trained. The accuracy for classification of each tissue type was 86.9%. Images were classified as either benign or malignant. The accuracy, sensitivity and specificity were 95.4%, 93.2% and 96.4%, respectively. We achieved 95% of accuracy for classification from ultrasound imaging using CNN. Deep learning could potentially help detecting and diagnosing the breast cancer, improving accuracy and productivity of diagnosing breast cancer by physician.

Surgical treatment of scirrhous gastric carcinoma

Scirrhous gastric carcinoma is a special type of gastric carcinomas and accompanied with highly interstitial fibrosis and diffuse cellular infiltration. Scirrhous gastric carcinoma is mainly composed of poor-differentiated adenocarcinoma and signet-ring cell carcinoma, with the clinical features of Borramann 4, thickening and stenosis of stomach wall, high peritoneal and lymph node metastases rates and poor prognosis. R0 resection and postoperative chemotherapy with S-1 as a main way are necessary for the patients who are able to undergo curable resection. The palliative operation should be applied to patients with ileus and urinary obstructions caused by peritoneal metastasis because of limited effect of surgical treatment. Chemo-therapy is the best choice for patients who are not able to undergo curable resection, conversional therapy can improve the prognosis of patients, and preoperative S-1/CDDP combination chemotherapy is an expectable therapy. Moreover, controlling peritoneal metastasis and effect of intraperitoneal chemotherapy are much anticipated. The efficiency of molecular targeted therapy by bevacizumab and gene therapy by adenovirus remain further study. Key words: Gastric neoplasms, scirrhous; Surgical procedures, operative; Chemotherapy

Carcinoma en cuirasse as an initial manifestation of inflammatory breast cancer.

Carcinoma en cuirasse is an uncommon clinical manifestation of metastatic cutaneous carcinoma characterized by diffuse sclerodermoid induration of the skin. The name was given in the first description by Velpeau in 1838 based on its resemblance to the steel breastplate of cuirassier (cavalry soldier) [1]. Other terms for this distinctive morphological variant of cutaneous metastasis include armoured cancer, Panzerkrebs, scirrhous carcinoma and Acarcine eburnee [2, 3]. Usually carcinoma en cuirasse occurs in patients with local tumour relapse after mastectomy, albeit in some subjects it develops as a presenting feature of primary breast cancer (BC) [4]. Rarely, this form of cutaneous metastasis was associated with other adenocarcinomas (e.g. carcinoma of the lung, kidney or gastrointestinal tract) [5].

Scirrhous breast carcinoma metastatic to the orbit: Imaging findings and volumetric analysis of the shrinking orbit

Scirrhous breast carcinoma metastatic to the orbit: Imaging findings and volumetric analysis of the shrinking orbit

A clinico-pathological study of malignant breast lump in a tertiary care hospital in Kosi region of Bihar, India

Background: Breast cancer has captured attention of surgeons throughout the ages with its uncertain cause. Despite centuries of meandering and scientific enquiry, breast cancer is still one of the most dreaded human diseases. The breast is a complex structure and any unnatural change affects the body and psyche of the person. The aim of this study was to observe age distribution, clinical signs and symptoms and pathology of malignant breast lump and draw a correlation between clinical and histological diagnosis of patients presenting with breast lump.Methods: Seventy six (76) cases of diagnosed malignant breast lump out of a total of 200 cases were included in this study. These cases were selected among patients visiting outdoor clinic of department of General Surgery in Katihar Medical College, Katihar. The selected cases belonged to different etiology, age group and sex.Results: Maximum number of malignant tumours was encountered in the 5th decade of age group of patients, followed by in 4th decade. All cases studied were females except 2 cases which were male. The commonest sign and symptoms of presentation was painless lump in the breast followed by painful mass in the breast along with associated features of ulceration of the skin, retraction of nipple and nipple discharge. Histologically, malignant tumours were maximally observed as infiltrating scirrhous carcinoma, followed by medullary carcinoma & papillary carcinoma.Conclusions: Breast cancer is a common cancer worldwide with varied presentation. Multimodality treatment approach is required for malignant breast lump which has shown improvement in both loco regional control and survival.

Abstract 5169: Omics approach to identify driver genes for peritoneal dissemination of gastric cancer cells

Abstract Background Little is known about the molecular mechanisms of peritoneal dissemination in gastric cancer cells. In this study, to clear the molecular mechanisms of accelerating the peritoneal dissemination, we performed to identify significant genes which give rise to peritoneal dissemination and poor prognosis of gastric cancer. We conducted expression array analysis in mice model of peritoneal dissemination and in 200 cases of gastric cancer cases, and compared with each other to identify driver genes. Methods As described previously, three parental scirrhous gastric carcinoma-derived cell lines (HSC-39, HSC-44PE and HSC-58) were established from human scirrhous gastric carcinoma. Moreover, inoculating each parental cell lines into the gastric wall of nude mice, four matched highly peritoneal-metastatic cell lines (HSC-39As8, HSC-44As3, HSC-58As1 and HSC-58As9) were established after 12 cycles of stepwise selection. To identify gene expression signatures for peritoneal dissemination, we performed expression analysis for matched parental and each resultant cell line. Next, to examine the relationship between gene expression signatures and clinical behaviors, we performed synthetic analysis of gene expression signatures from in vivo peritoneal dissemination mouse model data and expression data set containing 200 gastric tumors from the Singapore cohort. Results (1) Our synthetic analysis, EEM analysis, which tested the functionality of the input genes sets on the basis of their coherence, showed that one gene set from the 58As9 cell line harbored a coherently expressed subset of significant size. (2) We found 57 genes in the coherent subset which had clinical correlation. (3) We found that peritoneal metastases patients tended to show higher expression of such genes, and patients prognosis with higher expression of such genes tended to be poor. (4) Among such genes, we focused on chemokine(C-X-C motif) receptor 7(CXCR7). CXCR7 expression was significantly higher in 58As9 than in HSC58(P<0.005). We also found that overall survival of patients with CXCR7 high expression gastric cancer tended to be poorer than that with CXCR7 low expression gastric cancer in both the Singapore and Japanese cohorts. Conclusions In conclusion, synthetic analysis from two data sets indicated several candidate driver genes for strongly accelerating gastric cancer peritoneal dissemination, the current approach to compare gene signatures in vivo and clinical samples with accurate clinical annotations enabled us to identify brand-new driver candidate genes. Among them, CXCR7 might play an important role in peritoneal dissemination and CXCR7 might be a therapeutic target for suppression of gastric cancer peritoneal dissemination in the near future. Note: This abstract was not presented at the meeting. Citation Format: Sho Nambara, Junji Kurashige, Tomoko Saito, Hisateru Komatsu, Masami Ueda, Shotaro Sakimura, Hidenari Hirata, Ryutaro Uchi, Yuki Takano, Yoshiaki Shinden, Tomohiro Iguchi, Hidetoshi Eguchi, Keishi Sugimachi, Yoshihiko Maehara, Koshi Mimori. Omics approach to identify driver genes for peritoneal dissemination of gastric cancer cells. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5169. doi:10.1158/1538-7445.AM2015-5169

Decreased hormonal sensitivity after childbirth rather than the tumor size influences the prognosis of very young breast cancer patients.

PurposeThere is a significant difference in the mean tumor size between very young breast cancer patients and their elder counterparts. A simple comparison may show obvious prognostic differences. We investigated the prognostic impact of age by reducing the influence of the tumor size, which is thought to be a confounding factor.Patients and methodsWe investigated 1,880 consecutive pT1-4N0-3M0 breast cancer patients treated at less than 45 years of age between 1986 and 2002 and conducted a case–control study of breast cancer subjects less than 30 years of age. Each patient (Younger than 30) was matched with a corresponding control subject (Elder counterpart) based on an age 15 years above the patient’s age, a similar tumor size and a status of being within 1 year after surgery. In addition, we assessed 47 patients with pregnancy-associated breast cancer (PABC). The levels of hormone receptors were measured using an enzyme immunoassay (EIA), and receptor-positive cases were divided into “weakly” and “strongly” positive groups based on the median value. Years from the last childbirth (YFLC) was categorized as “recent” and “past” at the time point of 8 years.ResultsThere were fewer past YFLC cases, more partial mastectomy cases, a higher rate of scirrhous carcinoma or solid-tubular carcinoma in the Younger than 30 group than in the Elder counterpart group. The rates of a PgR-negative status in the Younger than 30 and Elder counterpart groups were 45.1 and 29.9%, respectively, As for the relationship between the PgR-negative rate and YFLC, the rates of a PgR-negative status in the past YFLC, nulliparous, recent YFLC and PABC groups were 31.9, 37.7, 44.4 and 65.7%, respectively. On the other hand, the rates of strongly positive cases were 42.6, 30.2, 22.2 and 8.6%, respectively. The 10-year recurrence-free survival rates in the Younger than 30, Elder counterpart and PABC groups were 61.7, 65.6 and 54.1%, respectively. The differences between the groups were not significant. In a multivariate analysis, independent prognostic facers included the number of lymph node metastases (4–9, HR:3.388, 95% CI 1.363–8.425, p = 0.0086, over 10, HR: 6.714, 2.033–22.177, p = 0.0018), solid-tubular carcinoma (HR 3.348, 1.352–8.292, p = 0.0090), scirrhous carcinoma (HR 2.294, 1.013–5.197, p = 0.0465) and past YFLC (HR 0.422, 0.186–0.956, p = 0.0387). An age younger than 30 was not found to be an independent prognostic factor.ConclusionsThe prognosis of the very young women was the same as their elder counterparts with a matched tumor size, and age was not identified to be an independent prognostic factor according to the multivariate analysis. Recent childbirth probably influences the prognosis of patients younger than 30 years of age with breast cancer by lowering hormonal sensitivity.